The therapeutic efficacy of radical prostatectomy and external beam radiation therapy in patients with different pathological patterns of prostate cancer

Jinge Zhao; Guangxi Sun; Fengnian Zhao; Junru Chen; Sha Zhu; Nanwei Xu; Haoyang Liu; Jiayu Liang; Xu Hu; Xingming Zhang; Yuchao Ni; Jindong Dai; Zhipeng Wang; Pengfei Shen; Zhenhua Liu; Ni Chen; Jiyan Liu; Hao Zeng

Asian Journal of Surgery (Oct 2023)

The therapeutic efficacy of radical prostatectomy and external beam radiation therapy in patients with different pathological patterns of prostate cancer

Jinge Zhao,
Guangxi Sun,
Fengnian Zhao,
Junru Chen,
Sha Zhu,
Nanwei Xu,
Haoyang Liu,
Jiayu Liang,
Xu Hu,
Xingming Zhang,
Yuchao Ni,
Jindong Dai,
Zhipeng Wang,
Pengfei Shen,
Zhenhua Liu,
Ni Chen,
Jiyan Liu,
Hao Zeng

Affiliations

Jinge Zhao: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, 610041, Chengdu, China
Guangxi Sun: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, 610041, Chengdu, China
Fengnian Zhao: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, 610041, Chengdu, China
Junru Chen: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, 610041, Chengdu, China
Sha Zhu: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, 610041, Chengdu, China
Nanwei Xu: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, 610041, Chengdu, China
Haoyang Liu: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, 610041, Chengdu, China
Jiayu Liang: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, 610041, Chengdu, China
Xu Hu: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, 610041, Chengdu, China
Xingming Zhang: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, 610041, Chengdu, China
Yuchao Ni: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, 610041, Chengdu, China
Jindong Dai: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, 610041, Chengdu, China
Zhipeng Wang: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, 610041, Chengdu, China
Pengfei Shen: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, 610041, Chengdu, China
Zhenhua Liu: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, 610041, Chengdu, China
Ni Chen: Department of Pathology, West China Hospital, Sichuan University, 610041, Chengdu, China
Jiyan Liu: Department of Biotherapy, West China Hospital, Sichuan University, 610041, Chengdu, China; Corresponding author. Department of Biotherapy, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, 610041, Chengdu, China.
Hao Zeng: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, 610041, Chengdu, China; Corresponding author. Department of Urology, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, 610041, Chengdu, China.

Journal volume & issue: Vol. 46, no. 10
pp. 4178 – 4185

Abstract

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Background: We aim to investigate the prognostic value of different pathological patterns of non-adenocarcinoma prostate cancers (PCa) in radical prostatectomy (RP) and external beam radiation therapy (EBRT). Methods: Data of 470,258 localized PCa patients between 2004 and 2016 were collected from the Surveillance, Epidemiology, and End Results database. Propensity score matching was performed to balance the baseline characteristics of patients in different groups. Kaplan–Meier curves and Cox regression were used for survival analysis. Overall survival (OS) and cancer-specific survival (CSS) were set as endpoints. Results: Totally, 1044 patients with non-adenocarcinoma patterns of PCa were included. Patients with small cell neuroendocrine carcinoma (SCNC) and neuroendocrine differentiation (NED) harbored the worst prognosis in both RP and EBRT among all pathological groups. RP exhibited superior effects to EBRT for this group of cases. Ductal carcinoma (DA) was also related to poorer survival outcomes versus PAC in both local therapies. Yet, for men with DA, both RP and EBRT still improved patients' prognosis against no local therapy (NLT), with RP being the superior modality. Cases harboring mucinous adenocarcinoma (MA) and signet ring cell carcinoma (SRCC) shared comparable clinical outcomes to men with PAC. However, for cases with MA, neither RP nor EBRT was related to better survival outcomes against NLT, while for patients with SRCC, both RP and EBRT prolonged patients’ survival with similar effects. Conclusions: Our study provided a comprehensive view of the treatment effect of RP and EBRT in non-adenocarcinoma PCa patients. These findings could facilitate clinicians in making therapeutic decision-making for non-adenocarcinoma patients.

Published in Asian Journal of Surgery

ISSN: 1015-9584 (Print)
Publisher: Elsevier
Country of publisher: Hong Kong
LCC subjects: Medicine: Surgery
Website: http://www.journals.elsevier.com/asian-journal-of-surgery/

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